Search results for: behavioural interventions

Authors: Sruthi Ramagiri, Rajeev Taliyan

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Background and purpose: Recent investigations on ischemia and reperfusion injury postulate that transient ischemia of remote organs after a prolonged ischemic insult confers neuroprotection. However, the molecular mechanisms of the remote limb ischemic post-conditioning (RIPOC) are yet to be elucidated. The current study was designed to investigate the protective mechanism of RIPOC against cerebral ischemic injury using global model of stroke. Materials and methods: Global ischemic reperfusion injury (IR) was achieved by 30 minutes ischemia of cerebral artery, followed by reperfusion for 24 hours. Induction of global ischemia was followed by 4 brief episodes (30 seconds each) of ischemia and reperfusion of femoral artery to accomplish RIPOC. 5-Hydroxy Decanoic acid (5-HD), a KATP channel blocker (20 mg/kg) was administered after induction of global ischemia and RIPOC intervention. Results: IR injury ensue significant behavioural deficits as manifested by rotarod performance and spontaneous locomotor activity when compared to sham control. Furthermore, IR injury significantly increased oxidonitrative stress and infarct volume as evidenced by biochemical parameters (MDA, GSH, Nitrite, SOD) and 2,3,5-triphenyltetrazolium chloride (TTC) staining respectively. Moreover, RIPOC intervention ameliorated the behavioural performance, attenuated the oxidative stress and infarct volume when compared to IR injury group. However, administration of 5-HD increased the oxidative stress and infarct size while deteriorating the behavioural parameters when compared to RIPOC group. Conclusions: In a nutshell, cerebral IR injury has significantly induced the neuronal damage, whereas RIPOC intervention decreased the neuronal injury. Moreover, 5-HD abolished the neuroprotection offered by RIPOC indicating the putative role of KATP channel opening in RIPOC against cerebral ischemic injury.

Keywords: RIPOC, cerebral injury, KATP channel, neuroprotection

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Authors: Edwina Owusu Panin, Kwame Baah Owusu Panin

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This abstract intends to demonstrate multiple strategies of autism management in Ghana by exploring the possibilities. The advantages of adopting creative art forms as a therapeutic method. Autism is a developmental disorder that includes social interaction, communication, and repetitive behaviours. In Ghana, as in many other countries, there is a rising demand for effective intervention and support for people with autism and their families. Creative arts such as music, dance, drama and visual arts have shown promise in promoting communication, social interaction and inclusion of people with autism. These art forms provide alternative channels for self-expression and can be powerful tools for autistic people to interact with the world, their friends and families around them. Creative art forms interventions have been found to improve social skills, improve emotion regulation, promote creativity and increase self-confidence in people with autism. This study examines existing programs and interventions in Ghana involving creative art forms for people with autism through a comparative analysis. It explores the different approaches, methods and results of these interventions. By comparing and evaluating these programs, the study aims to identify best practices, challenges and areas for development in managing autism through the creative arts in Ghana. Although many schools and rehabilitation centres employ various forms in therapeutic approaches for autism. There is no comparative analysis of which type of autism and which creative art forms is suitable. The results of this study will contribute to the development of evidence-based practices for the management of autism in Ghana. It provides valuable information about the effectiveness of creative arts interventions and helps inform policy makers, educators, therapists and other stakeholders involved in autism support. Ultimately, the goal is to improve the well-being and quality of life of people with autism in Ghana and their families by promoting inclusive and accessible interventions that harness the power of creative art forms.

Keywords: autism, therapeutic, creative art, art form

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Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

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Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

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Authors: Ahmed Kadry, Gwyn Dodd

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There has been a growing call globally for police forces to embed evidence-based policing research methods into police interventions in order to better understand and evaluate their impact. This research study highlights the success and challenges that police forces may encounter when trying to embed evidence-based research methods within their organisation. 10 in-depth qualitative interviews were conducted with police officers and staff at Greater Manchester Police (GMP) who were tasked with integrating evidence-based research methods into their operational interventions. The findings of the study indicate that with adequate resources and individual expertise, evidence-based research methods can be applied to operational work, including the testing of initiatives with strict controls in order to fully evaluate the impact of an intervention. However, the findings also indicate that this may only be possible where an operational intervention is heavily resourced with police officers and staff who have a strong understanding of evidence-based policing research methods, attained for example through their own graduate studies. In addition, the findings reveal that ample planning time was needed to trial operational interventions that would require strict parameters for what would be tested and how it would be evaluated. In contrast, interviewees underscored that operational interventions with the need for a speedy implementation were less likely to have evidence-based research methods applied. The study contributes to the wider literature on evidence-based policing by providing considerations for police forces globally wishing to apply evidence-based research methods to more of their operational work in order to understand their impact. The study also provides considerations for academics who work closely with police forces in assisting them to embed evidence-based policing. This includes how academics can provide their expertise to police decision makers wanting to underpin their work through evidence-based research methods, such as providing guidance on how to evaluate the impact of their work with varying research methods that they may otherwise be unaware of.  

Keywords: evidence based policing, evidence-based practice, operational policing, organisational change

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Authors: Joshua Midha

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The basis for information campaigns and behavioral interventions has long reigned as a tactic. From the Soviet-era propaganda machines to the opinion hijacks in Iran, these measures are now commonplace and are used for dissemination and disassembly. However, the use of these tools for strategic diffusion, specifically in a counter-terrorism setting, has only been explored on the surface. This paper aims to introduce a larger conceptual portion of guided information campaigns into preexisting terror cells and situations. It provides an alternative, low-risk intervention platform for future military strategy. This paper highlights a theoretical framework to lay out the foundationary details and explanations for behavioral interventions and moves into using a case study to highlight the possibility of implementation. It details strategies, resources, circumstances, and risk factors for intervention. It also sets an expanding foundation for offensive PsyOps and argues for tactical diffusion of information to battle extremist sentiment. The two larger frameworks touch on the internal spread of information within terror cells and external political sway, thus charting a larger holistic purpose of strategic operations.

Keywords: terrorism, behavioral intervention, propaganda, SNA, extremism

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Authors: Lauren A. Bailey, Amber R. Childs, Nicola C. James, Murray I. Duncan, Alexander Winkler, Warren M. Potts

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Changes in behaviour and physiology are the most important responses of marine life to anthropogenic impacts such as climate change and over-fishing. Behavioural changes (such as a shift in distribution or changes in phenology) can ensure that a species remains in an environment suited for its optimal physiological performance. However, if marine life is unable to shift their distribution, they are reliant on physiological adaptation (either by broadening their metabolic curves to tolerate a range of stressors or by shifting their metabolic curves to maximize their performance at extreme stressors). However, since there are links between fish physiology and behaviour, changes to either of these traits may have reciprocal interactions. This paper reviews the current knowledge of the links between the behaviour and physiology of fishes, discusses these in the context of exploitation and climate change, and makes recommendations for future research needs. The review revealed that our understanding of the links between fish behaviour and physiology is rudimentary. However, both are hypothesized to be linked to stress responses along the hypothalamic pituitary axis. The link between physiological capacity and behaviour is particularly important as both determine the response of an individual to a changing climate and are under selection by fisheries. While it appears that all types of capture fisheries are likely to reduce the adaptive potential of fished populations to climate stressors, angling, which is primarily associated with recreational fishing, may induce fission of natural populations by removing individuals with bold behavioural traits and potentially the physiological traits required to facilitate behavioural change. Future research should focus on assessing how the links between physiological capacity and behaviour influence catchability, the response to climate change drivers, and post-release recovery. The plasticity of phenotypic traits should be examined under a range of stressors of differing intensity in several species and life history stages. Future studies should also assess plasticity (fission or fusion) in the phenotypic structuring of social hierarchy and how this influences habitat selection. Ultimately, to fully understand how physiology is influenced by the selective processes driven by fisheries, long-term monitoring of the physiological and behavioural structure of fished populations, their fitness, and catch rates are required.

Keywords: climate change, metabolic shifts, over-fishing, phenotypic plasticity, stress response

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Authors: Jeremy Bekker, Guy Salazar

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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.

Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention

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Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

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Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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Authors: Van Truong Pham

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Background: Self-management was described as a potential strategy for blood pressure control in patients with hypertension. However, the effects of self-management interventions on blood pressure, self-efficacy, medication adherence, and body mass index (BMI) in older adults with hypertension have not been systematically evaluated. We evaluated the effects of self-management interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP), self-efficacy, medication adherence, and BMI in hypertensive older adults. Methods: We followed the recommended guidelines of preferred reporting items for systematic reviews and meta-analyses. Searches in electronic databases including CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science, and other sources were performed to include all relevant studies up to April 2019. Studies selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized intervention effects as Hedges' g values and 95% confidence intervals (CI) using a random-effects model. Data were analyzed using Comprehensive Meta-Analysis software 2.0. Results: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly improved blood pressure control, self-efficacy, medication adherence, whereas the effect of self-management on BMI was not significant in older adult patients with hypertension. The following Hedges' g (effect size) values were obtained: SBP, -0.34 (95% CI, -0.51 to -0.17, p < 0.001); DBP, -0.18 (95% CI, -0.30 to -0.05, p < 0.001); self-efficacy, 0.93 (95%CI, 0.50 to 1.36, p < 0.001); medication adherence, 1.72 (95%CI, 0.44 to 3.00, p=0.008); and BMI, -0.57 (95%CI, -1.62 to 0.48, p = 0.286). Conclusions: Self-management interventions significantly improved blood pressure control, self-efficacy, and medication adherence. However, the effects of self-management on obesity control were not supported by the evidence. Healthcare providers should implement self-management interventions to strengthen patients' role in managing their health care.

Keywords: self-management, meta-analysis, blood pressure control, self-efficacy, medication adherence, body mass index

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Authors: Kailen Krame

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This paper presents a review of the literature on the efficacy of mindfulness-based interventions for reducing occupational stress and burnout among K-12 educators. An in-depth discussion of the incidence and impact of teacher stress and burnout is provided, as a wealth of literature indicates that this issue is of growing concern and has important implications not only for individual educators but also for students and the school as an organization. Given the evidence of a link between teacher wellbeing and student outcomes, this topic is worth further investigation in order to better understand sources of stress and burnout and propose adequate coping strategies for today’s educators. As a potential solution to teacher stress and burnout, mindfulness-based interventions are reviewed in-depth, and an overview of the history, diverse application, and effects of mindfulness practice are provided. Relevant outcomes of educator mindfulness training presented in the literature include increased emotional regulation, self-efficacy, and personal wellbeing, among several others. Lastly, additional implications and benefits of educator mindfulness training are explored, limitations of the current research are reviewed, and apparent best practices are proposed.

Keywords: educator burnout, emotional regulation, mindfulness, self-efficacy, stress-reduction

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Authors: Yasaman Mohammadi

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Emotion regulation is a complex process that allows individuals to manage and modulate their emotional responses in order to adaptively respond to environmental demands. As individuals age, emotion regulation abilities may decline, leading to an increased vulnerability to mood disorders and other negative health outcomes. Advances in neuroimaging techniques have greatly enhanced our understanding of the neural substrates underlying emotion regulation and age-related changes in these neural systems. Additionally, genetic research has identified several candidate genes that may influence age-related changes in emotion regulation. In this paper, we review recent findings from neuroimaging and genetic research on age-related changes in the neural substrates of emotion regulation, highlighting the mechanisms and consequences of these changes. We also discuss potential interventions, including cognitive and behavioral approaches, that may be effective in mitigating age-related declines in emotion regulation. We propose that a better understanding of the mechanisms underlying age-related changes in emotion regulation may lead to the development of more targeted interventions aimed at promoting healthy emotional functioning in older adults. Overall, this paper highlights the importance of studying age-related changes in emotion regulation and provides a roadmap for future research in this field.

Keywords: emotion regulation, aging, neural substrates, neuroimaging, emotional functioning, healthy aging

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Authors: Daniel D'Souza, Ping Zou

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The period before, during, and after menopause is a sensitive time for women as they experience intense physical and psychological health changes and symptoms. These changes accompany the hormonal changes that mark the end of a woman’s reproductive age. To help mitigate and cope with these changes, prompt and correct treatment is needed. eHealth has emerged as a branch of telemedicine in the past few decades as an alternate avenue for patients to receive care quickly and conveniently, as it relies on the Internet and computers. Within the past few years, eHealth has also given rise to mHealth, which is the use of personal mobile devices to receive treatment and care. However, there is a lack of study on their use for menopause. This review aimed to review and summarize the literature for eHealth or mHealth and menopause. Several databases related to women’s health and digital health were searched for original studies about eHealth or mHealth and menopause. The search yielded 25 results. The results were generally positive, with these interventions being feasible and having positive effects on physical and psychosocial outcomes. However, several issues were raised regarding their design process that may inadvertently prevent these interventions from addressing the needs of all potential users. Therefore, while eHealth and mHealth certainly represent a future model of healthcare delivery for menopausal women, further research and design modifications are needed before this can happen.

Keywords: eHealth, menopause, mHealth, midlife women

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Authors: Jamil Ahmed, Li P. Wong, Yan P. Chua

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The United Nation's sustainable development goals include the target to ensure access to water and sanitation for all; however, very few studies have assessed school-based drinking water in Pakistan. The purpose of this study was to characterize water quality in primary schools of Pakistan and to characterize how recent WASH interventions were associated with school water quality. We conducted a representative cross-sectional study of primary schools in the Sindh province of Pakistan. We used structured observations and structured interviews to ascertain the school’s WASH conditions. Our primary exposures of interest were the implementation of previous WASH interventions in the school and the water source type. Outcomes of interest included water quality (measured by various chemical and microbiological indicators) and water availability at the school’s primary drinking water source. We used log-binomial regression to characterize how WASH exposures were associated with water quality outcomes. We collected data from 256 schools. Groundwater was the primary drinking water source at most schools (87%). Water testing showed that 14% of the school’s water had arsenic above the WHO recommendations, and over 50% of the water samples exceeded recommendations for both lead and cadmium. A majority of the water sources (52%) had fecal coliform contamination. None of the schools had nitrate contamination (0%), and few had fluoride contamination (5%). Regression results indicated that having a recent WASH intervention at the school was not associated with either arsenic contamination (prevalence ratio=0.97; 95% CI: 0.46-2.1) or with fecal coliform contamination (PR=0.88; 95% CI: 0.67-1.17). Our assessment unveiled several water quality gaps that exist, including high heavy metal and fecal contamination. Our findings will help various stakeholders to take suitable action to improve water quality in Pakistani schools.

Keywords: WASH interventions, water quality, primary school children, heavy metals

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Authors: Anneke Van Biljon

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Background: Exercise is a primary form of preventing and improving cardiometabolic disease risk factors; however specific exercise variables and their associated health benefits in children are inconclusive. A preliminary study revealed that different exercise variables may improve particular cardiometabolic health benefits. Objectives: This study further investigated the specific cardiometabolic health benefits associated with three isocaloric exercise interventions set at different intensities. Methods: Hundred-and-twenty (n = 120) participants between the ages of 10 – 14 years old were assigned to four different study groups 1. High intensity interval training (HIIT) at > 80% MHR 2. Moderate intensity continuous training (MICT) at 65% – 70% MHR 3. Alternative intensities (ALT) of HIIT and MICT 4. Control group. Exercise interventions were designed to generate isocaloric workloads of ~154.77 kcal per session, three times per week for five weeks. The one-way ANOVA test established comparisons between group means. Post hoc tests were calculated to determine specific group differences. Results: Although, all exercise groups improved cardiometabolic health, the MICT group showed greater improvements in fasting glucose (-9.30%), whereas cardiorespiratory fitness increased most by 31.33% (p = 0.000) within the HIIT group. Finally, ALT group recorded overall superior and additional cardiometabolic health benefits compared with both MICT and HIIT groups. Conclusion: The findings of this study indicate that superior benefits may be elicited when combining and alternating MICT and HIIT. These results provide specific exercise recommendations for achieving optimal and substantial cardiometabolic health benefits in children which will contribute towards achieving the health-related Sustainable Development Goals for 2030.

Keywords: cardiometabolic disease risk factors, exercise, pediatrics, interventions

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Authors: Louise Fitzgerald, John Allman

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Introduction: Having previously engaged in a meditation-based programme (MBP) for staff in general practice, we explore the evidence and extent to which MBPs are employed in the workplace. Aim of the study: We aim to understand the current workplace MBP intervention literature, which will help inform the suitability of these interventions within the workplace domain. Objectives: Uptake of MBPs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. We will discuss the current MBP literature, including the large variability across MBPs and the associated difficulties in evaluating their efficacy. Learning points: 1) MBPs have a positive impact on cognitive function including concentration and memory and as such job performance. MBPs appear to have a positive impact on objective and subjective job satisfaction, productivity, motivation and work engagement. Meditation in the workplace may have positive impacts on mental health issues - including stress reduction and depression. 2) From our review MBPs appear to be implementable in a wide range of professions and work contexts - regardless of individual factors. Given many companies are focusing on health and wellbeing of employees, this could be included in employee wellbeing programmes. 3) Despite the benefits of mindfulness and meditation interventions in psychosocial workplace health and work performance the long-term efficacy has yet to be fully determined.

Keywords: meditation-based programmes, mindfulness, meditation, well-being

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Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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Authors: Mahmoud Ahmad Mahmoud

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The surge in unemployment among nations and the understanding of the important role played by entrepreneurship in job creation by researchers and policy makers have steered to the postulation that entrepreneurship activities can be spurred through the development of entrepreneurial intentions. Notwithstanding, entrepreneurial intention studies are very scarce in the developing world especially in the African continent. Even among the developed countries, studies of entrepreneurial intention were mostly focused on the undergraduate candidates. This paper therefore, aimed at filling the gap by employing the descriptive quantitative survey method to examine the entrepreneurial intention of 158 Nigerian postgraduate candidates of Universiti Utara Malaysia (UUM), comprising 46 Masters and 112 PhD candidates who are studying in the College of Business (COB), College of Arts and Sciences (CAS) and College of Legal, Government and International Studies (COLGIS), the theory of planned behaviour (TPB) model was used due its reputable validity, with attitudes, subjective norms and perceived behavioural control as the independent variables. Preliminary analysis and data screening were conducted which qualifies the data to the multivariate analysis assumptions. The reliability test was performed using the Cronbach Alpha method which shows all variables as reliable with a value of >0.70. However, the data is free from the multicollinearity issue with all factors in the Pearson correlation having <0.9 value and the VIF having <10. Regression analysis has shown the sufficiency and predictive capability of the TPB model to entrepreneurship intention with attitude, subjective norms and perceived behavioural control being positively and significantly related to the entrepreneurial intention of Nigerian postgraduates. Considering the Beta values, perceived behavioural control emerged as the strongest factor that influences the postgraduates entrepreneurial intention. Developing countries are therefore, recommended to make efforts in redesigning their entrepreneurship development policies to fit candidates of the highest level of academia. Further studies should replicate in a larger sample that comprises more than one university and more than one developing country.

Keywords: attitude, entrepreneurial intention, Nigeria, perceived behavioral control, postgraduates, subjective norms

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Authors: Charita Jashi

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The aim of the paper is to explore the role of social marketing in changing the behavior of consumers on road safety, identify critical aspects and priority needs which impede the implementation of road safety program in Georgia. Given the goals of the study, a quantitative method was used to carry out interviews for primary data collection. This research identified the awareness level of road safety, legislation base, and marketing interventions to change behavior of drivers and pedestrians. During several years the non-governmental sector together with the local authorities and media have been very intensively working on the road safety issue in Georgia, but only seat-belts campaign should be considered rather successful. Despite achievements in this field, efficiency of road safety programs far from fulfillment and needs strong empowering.

Keywords: road safety, social marketing interventions, behavior change, well-being

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Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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Authors: Carla Nardelli, Jérome Holtzmann, Céline Baeyens, Catherine Bortolon

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Background. Emotion regulation (ER) is a process associated with difficulties in mental health. Given its transdiagnostic features, its improvement could facilitate the recovery of various psychological issues. A limit of current studies is the lack of knowledge regarding whether available interventionsimprove ER flexibility (i.e., the ability to implement ER strategies in line with contextual demands), even though this capacity has been associated with better mental health and well-being. Therefore, the aim of the study is to test the efficacy of a 9-weeks ER group program (the Affect Regulation Training-ART), using the most appropriate measures (i.e., experience sampling method) in a student population. Plus, the goal of the study is to explore the potential mediative role of ER flexibility on mental health improvement. Method. This Randomized Controlled Trial will comparethe ER program group to an active control group (a relaxation program) in 100 participants. To test the mediative role of ER flexibility on mental health, daily measures will be used before, during, and after the interventions to evaluate the extent to which participants are flexible in their ER. Expected outcomes. Using multilevel analyses, we expect an improvement in anxious-depressive symptomatology for both groups. However, we expect the ART group to improve specifically on ER flexibility ability and the last to be a mediative variable on mental health. Conclusion. This study will enhance knowledge on interventions for students and the impact of interventions on ER flexibility. Also, this research will improve knowledge on ecological measures for assessing the effect of interventions. Overall, this project represents new opportunities to improve ER skills to improve mental health in undergraduate students.

Keywords: emotion regulation flexibility, experience sampling method, psychological intervention, emotion regulation skills

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Authors: Reham Barakat

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Over the last few decades, the influence of International Financial Institutions (IFIs), especially the World Bank (WB), has significantly increased. Since the early 1980s, IFIs have assumed greater role, especially in developing countries; their total lending has dramatically increased, affecting billions of people in their Borrower States. Though the purpose of the development assistance provided by IFIs is to alleviate poverty and promote economic and social development in their member countries, IFIs have been subject to massive criticism by civil society institutions, international NGOs and local communities for the harmful environmental, social and economic impacts resulting from their development interventions in borrower countries, such as deforestation, displacement of indigenous peoples, and unemployment. While the role of IFIs has expanded over time, affecting billions of people, their accountability mechanisms remained behind and were criticized for lacking sufficient independency and enforceability. The serious adverse environmental impacts of the World Bank’s funded projects, along with their weak accountability mechanisms, raises the question of 'To what extent IFIs should be held internationally responsible for the harmful environmental consequences arising from their development interventions?'. This paper argues that IFIs are legally responsible for the harmful environmental consequences arising from their development interventions. The study (i) identifies the applicable laws and relevant primary rules from which the international environmental obligations of IFIs towards their borrower countries are derived (ii) assesses the World Bank’s compliance to the principles of the International Environmental Law including the precautionary principle, the polluter pays principle, and the principle of Good-Neighborliness, (iii) assesses the World Bank’s current internal accountability mechanisms for harmful environmental impacts resulting from the World Bank’s funded projects, and finally (iv) identifies the appropriate dispute settlement mechanisms to which states and non-state actors could raise their claims against IFIs for harmful environmental consequences arising from their interventions.

Keywords: international environmental law, international financial institutions, international responsibility, world bank, environmental and social safeguards

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Authors: Amina El-Warari, Agata Vitale, Laura Caulfield, Jennifer Kinloch

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Background: Unemployment levels among refugees in the UK are much higher than voluntary migrants and UK-born citizens. The lack of employment and/or of suitable employment has detrimental consequences on refugees’ ability to integrate and become active citizens in the host country. Research indicates that, when individuals are forced to migrate, one of the most significant aspects to building their identity is their previous profession; this particularly applies to qualified refugees. Despite this, there is little support available to them. The current study is set in this context and aims to explore highly qualified refugees’ employment-related experiences in the UK as well as their suggestions on how to develop specific interventions that can support them in finding suitable employment. Methods: A qualitative study design was employed. Qualitative methods are in fact well suited to research with refugees, as they allow them to give their direct opinion, rather than this being filtered by stakeholders. Listening to ‘the refugee’s voice’ means developing ‘a refugee centered perspective’ where the diverse narratives told by participants are organized to tell their direct collective story. A total of 12 refugees, attending a non-profit refugee organization in the south-west of England, took part in the study. The selection criteria were being over 18, having a level of English that allows them to sustain a conversation, and having a University degree and/or professional qualification. All participants were interviewed individually; the data were transcribed and analyzed thematically. Findings: Participants had very little support in finding suitable employment; this often only consisted of a few sessions in their local job centers and English tutorials. They indicated that being unemployed/underemployed negatively affected their sense of identity, their acculturative stress, and their in-group/ out-group relations. They suggested that specific employment interventions for qualified refugees should be delivered to them individually in order to address their specific needs. Furthermore, most participants suggested that these interventions should support them in volunteering in organizations that match their skills/ qualifications. They also indicated that the employment interventions should support them in having their qualifications recognized in the UK as well as building links with universities/ centers where they can receive adequate training on how to understand and adapt to the employments needs in the UK. Conclusions: These findings will provide the basis for the second stage of the research where specific employment interventions will be designed and tested with highly qualified refugees. In addition, these findings shed light refugee integration policy.

Keywords: employment interventions, identity, integration, qualified refugees

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Authors: Nargiza Nuralieva

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This meta-analysis investigates the effectiveness of mental health interventions tailored for international students in China, with a specific focus on Uzbek students and Silk Road scholarship recipients. The comprehensive literature review synthesizes existing studies, papers, and reports, evaluating the outcomes, limitations, and cultural considerations of these programs. Data selection targets mental health programs for international students, honing in on a subset analysis related to Uzbek students and Silk Road scholarship recipients. The analysis encompasses diverse outcome measures, such as reported stress levels, utilization rates of mental health services, academic performance, and more. Results reveal a consistent and statistically significant reduction in reported stress levels, emphasizing the positive impact of these interventions. Utilization rates of mental health services witness a significant increase, highlighting the accessibility and effectiveness of support. Retention rates show marked improvement, though academic performance yields mixed findings, prompting nuanced exploration. Psychological well-being, quality of life, and overall well-being exhibit substantial enhancements, aligning with the overarching goal of holistic student development. Positive outcomes are observed in increased help-seeking behavior, positive correlations with social support, and significant reductions in anxiety levels. Cultural adaptation and satisfaction with interventions both indicate positive outcomes, underscoring the effectiveness of culturally sensitive mental health support. The findings emphasize the importance of tailored mental health interventions for international students, providing novel insights into the specific needs of Uzbek students and Silk Road scholarship recipients. This research contributes to a nuanced understanding of the multifaceted impact of mental health programs on diverse student populations, offering valuable implications for the design and refinement of future interventions. As educational institutions continue to globalize, addressing the mental health needs of international students remains pivotal for fostering inclusive and supportive learning environments.

Keywords: international students, mental health interventions, cross-cultural support, silk road scholarship, meta-analysis

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Authors: L. Matthewman, J. Nowlan

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Background: Holistic or Integrative Psychology emphasizes the interdependence of physiological, spiritual and psychological dynamics. Studying “wholeness and well-being” from a systems perspective combines innovative psychological science interventions with Eastern orientated healing wisdoms and therapies. The literature surrounding holistic/integrative psychology focuses on multi-stage interventions in attempts to enhance the mind-body experiences of well-being for participants. This study proposes a new single stage model as an intervention for UG/PG students, time-constrained workplace employees and managers/leaders for improved well-being and life enhancement. The main research objective was to investigate participants’ experiences of holistic and mindfulness interventions for impact on emotional well-being. The main research question asked was if single stage holistic interventions could impact on psychological well-being. This is of consequence because many people report that a reason for not taking part in mind-body or wellness programmes is that they believe that they do not have sufficient time to engage in such pursuits. Experimental Approach: The study employed a mixed methods pre-test/post-test research design. Data was analyzed using descriptive statistics and interpretative phenomenological analysis. Purposive sampling methods were employed. An adapted mindfulness measurement questionnaire (MAAS) was administered to 20 volunteer final year UG student participants prior to the single stage intervention and following the intervention. A further post-test longitudinal follow-up took place one week later. Intervention: The single stage model intervention consisted of a half hour session of mindfulness, yoga stretches and head and neck massage in the following sequence: Mindful awareness of the breath, yoga stretches 1, mindfulness of the body, head and neck massage, mindfulness of sounds, yoga stretches 2 and finished with pure awareness mindfulness. Results: The findings on the pre-test indicated key themes concerning: “being largely unaware of feelings”, “overwhelmed with final year exams”, “juggling other priorities” , “not feeling in control”, “stress” and “negative emotional display episodes”. Themes indicated on the post-test included: ‘more aware of self’, ‘in more control’, ‘immediately more alive’ and ‘just happier’ compared to the pre-test. Themes from post-test 2 indicated similar findings to post-test 1 in terms of themes. but on a lesser scale when scored for intensity. Interestingly, the majority of participants reported that they would now seek other similar interventions in the future and would be likely to engage with a multi-stage intervention type on a longer-term basis. Overall, participants reported increased psychological well-being after the single stage intervention. Conclusion: A single stage one-off intervention model can be effective to help towards the wellbeing of final year UG students. There is little indication to suggest that this would not be generalizable to others in different areas of life and business. However this study must be taken with caution due to low participant numbers. Implications: Single stage one-off interventions can be used to enhance peoples’ lives who might not otherwise sign up for a longer multi-stage intervention. In addition, single stage interventions can be utilized to help participants progress onto longer multiple stage interventions. Finally, further research into one stage well-being interventions is encouraged.

Keywords: holistic/integrative psychology, mindfulness, well-being, yoga

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Authors: Fatma Ismailia, Malek Saihi

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This research provides an explanation of exchange incentives on the Tunis stock market from a behavioural point of view. The elucidation of the anomalies of excessive volume of transactions and that of excessive volatility cannot be done without the recourse to the psychological aspects of investors. The excessive confidence has been given the predominant role for the explanation of these phenomena. Indeed, when investors store increments, they become more confident about the precision of their private information and their exchange activities then become more aggressive on the subsequent periods. These overconfident investors carry out the intensive exchanges leading to an increase of securities volatility. The objective of this research is to identify whether the trading volume and the excessive volatility of securities observed on the Tunisian stock market come from the excessive exchange of overconfident investors. We use a sample of daily observations over the period January 1999 - October 2007 and we relied on various econometric tests including the VAR model. Our results provide evidence on the importance to consider the bias of overconfidence in the analysis of Tunis stock exchange specificities. The results reveal that the excess of confidence has a major impact on the trading volume while using daily temporal intervals.

Keywords: overconfidence, trading volume, efficiency, rationality, anomalies, behavioural finance, cognitive biases

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Authors: Avigail Moor

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Rape and sexual assault have been widely linked to severe psychological sequelae, the recovery from which often requires professional help. Thanks to the current shift in societal attitudes towards sexual violence, the victim's perspective is increasingly being heard. The present study is yet another step in that direction. Through the investigation of what recovered survivors of sexual assault identify as the therapeutic interventions that most assisted them in overcoming their trauma, guidelines for optimal sexual assault treatment are established. These receive further support from a comparison with expert therapists as to what they view as being most conducive to recovery from rape. In-depth semi-structured interviews were conducted with 15 survivors who have experienced a successful course of therapy and 15 therapists with extensive expertise in the field. The results document considerable agreement between the two perspectives, which share much in common. First, irrespective of the specific techniques involved, both survivors and therapists placed the greatest importance on a respectful and validating therapeutic relationship, that operates to counter the dehumanization and degradation entailed in the assault. In addition, specific interventions were identified, which include the reprocessing of all rape-specific peri-traumatic reactions coupled with the intentional countering of their consequences within the therapeutic relationship. Together, these reports provide a detailed account of post-rape treatment needs and the interventions required for their effective resolution.

Keywords: sexual assault, rape, treatment efficacy, survivors

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Authors: Clare Victoria Martin

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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.

Keywords: performance, positive psychology, thriving, workplace well-being

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Authors: Laila Khawaja

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In recent years, an increasing emphasis has been placed on measuring program implementation, in part because of the great variability in how complex interventions are delivered in real-life settings. There is an increased awareness that while conducting process evaluations, one should aim to identify and understand the complexities of intervention if they are to be used for future intervention development or the strategies needed to implement the same intervention in a different setting. Complex interventions are public health interventions that are not drugs or surgical procedures but have many potential active aspects of intervention. In this paper, process evaluations are aligned with MRC guidelines to identify contextual factors related to outcomes to assess the quality of implementation. This paper briefly discusses the perceptions of research team on the implementation of the intervention of ‘Engaging Adolescents in Changing Behaviour’ (EACH-B), a school-based complex intervention study aiming to improve diet and physical activity among adolescents aged 12-13 years. Through qualitative interviews and focus groups with 10 staff members, we aimed to understand their experiences and reflections on implementing the EACH-B trial delivered in 49 Schools around Hampshire, England. Data were uploaded into NVivo, and analysis was conducted using thematic analysis. The investigation revealed two overarching themes: (a) how the communication patterns with teachers were impacted during the delivery of implementation and (b) what were the team’s strategies to keep logistics aligned with the research process that impacted the overall implementation of the trial. The paper informs adaptation strategies used by the research team to establish and maintain effective communication with the teachers as well as the thoughtfulness of the team’s logistic strategy for the successful delivery of the trial.

Keywords: complex interventions, process evaluation, adaptation strategies, randomised controlled trial

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Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

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BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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